532 results
Search Results
2. Orthopedic approaches for bone sarcoma: A bibliometric review of the 50 most cited papers
- Author
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Markowitz, Moses I., Donato, Zachary, Constantinescu, David S., Al-Hardan, Waleed, Baron, Max, and Crawford, Brooke
- Published
- 2023
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3. Bibliometric analysis of 100 most influential papers related to septic arthritis of native joints
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Karaismailoglu, Berna, Koroglu, Ali Egemen, Celayir, Arin, and Karaismailoglu, Bedri
- Published
- 2022
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4. Characteristics and trends of the most cited papers in robotic assisted arthroplasty
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Mahmoud, Rami H., Lizardi, Juan J., Weinerman, Jonathan, Vanden Berge, Dennis J., Constantinescu, David S., and Yakkanti, Ramakanth
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- 2022
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5. The 50 most influential papers pertaining to the Ilizarov method: A bibliometric analysis
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Murphy, Ben, Irwin, Shane, and Condon, Finbarr
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- 2022
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6. The 50 most influential papers pertaining to the Ilizarov method: A bibliometric analysis
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Ben Murphy, Shane Irwin, and Finbarr Condon
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Orthopedics and Sports Medicine - Abstract
The Ilizarov method has become a widely recognised surgical technique. A bibliometric analysis of the 50 most-cited publications relating to the Ilizarov method was carried out. Cumulative number of citations was 4,918. Mean number of citations was 98. h-index was 50. Impact factor of these journals ranged from 0.5-5.082. Our study suggests that a highly cited and influential paper likely originated from an American journal with a high impact factor and was published in the 1990s/2000s. Our compilation of the 50 most influential papers on the Ilizarov method will prove invaluable to those in training and those involved in further advancing the technique.
- Published
- 2022
7. Bibliometric analysis of 100 most influential papers related to septic arthritis of native joints
- Author
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Berna Karaismailoglu, Ali Egemen Koroglu, Arin Celayir, and Bedri Karaismailoglu
- Subjects
Orthopedics and Sports Medicine - Abstract
Bibliometric studies have gained popularity since they are able to define the characteristics of articles on specific subjects. The aim of this study was to analyze the characteristics of 100 most-cited papers related to septic arthritis of the native joints.Web of Science database was analyzed and 100 most-cited articles about septic arthritis were determined. The characteristics of the articles including publication year, country, journal, study type, and sponsorship were recorded and investigated for any possible relationship with citation numbers. The visualization of the most commonly used keywords was made by software.The highest citation number and density were 309 and 21.6, respectively. The highest contribution was from the USA with 44 articles. The most common study type was case series with 26 articles. Annals of the Rheumatic Diseases journal had the highest number of articles with 8 papers. Fifteen studies were funded. The average citation density of review articles was significantly higher than in clinical and basic science studies (p 0.001). Citation density was positively correlated with publication year and institution number, while it was negatively correlated with the level of evidence.This study summarizes the general characteristics and research trends of the 100 most influential septic arthritis papers. Citation density and level of evidence performance were better in more recent articles. Additionally, citation density was higher in papers that included contributions from multiple institutions and papers with a high level of evidence. However, a high level of evidence is lacking indicating the need for better study design in future research.
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- 2022
8. Characteristics and trends of the most cited papers in robotic assisted arthroplasty
- Author
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Rami H. Mahmoud, Juan J. Lizardi, Jonathan Weinerman, Dennis J. Vanden Berge, David S. Constantinescu, and Ramakanth Yakkanti
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Orthopedics and Sports Medicine - Abstract
To compile and analyze the top 50 most frequently cited articles published on robotic-assisted arthroplasty, allowing clinicians to effectively identify the most influential literature pertaining to this topic.Guidelines set by the Preferred Reporting Items for Systematic Reviews were used as the foundation for data collection and analysis. All papers pertaining to robotic-assisted arthroplasty were retrieved using the Scopus database. Data including: manuscript title, authors, total citation count, level of evidence, journal, publication year, and country of publication was extracted from a final list of articles.The top 50 publications regarding robotic assisted arthroplasty were cited a total of 4530 times (including self-citations), with an average total of 91. The years with the most publications in the top 50 were: 2017, 2018, and 2019, producing 7, 6, and 5 papers, respectively. Only 4 papers in the top 50 were published prior to the year 2003. The most common level of evidence was level V, and the most common category was Clinical Outcomes (74%). The United States contributed half of the 50 articles, and Princess Grace Hospital and University of London were the most contributory institutions, each with 6 of the top 50 articles.This analysis provides a comprehensive review of the most cited and influential papers in robotic-assisted arthroplasty. Understanding these trends in the literature will ultimately pave the way for physicians and researchers to continue to innovate and research in a targeted manner as they gain an understanding of what has been studied and what remains inadequately explored.3.
- Published
- 2022
9. Tibial Tubercle Osteotomy (TTO): A Review of Impactful Papers in the Literature
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Costello II, Joseph P., Patel, Nikhil N., Chen, Justin A., Tandron, Marissa C., Goldenberg, Brandon, and Baraga, Michael G.
- Abstract
Tibial tubercle osteotomy (TTO) is a procedure that can be used as an alternative to total knee arthroplasty (TKA) or to address patellar instability in patients experiencing dislocation events. The purpose of this paper is to systematically evaluate the most cited articles pertaining to TTO through bibliometric analysis.
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- 2024
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10. A critical analysis of the paper – Single-step scaffold-based cartilage repair in the knee: A systematic review
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Vaish, Abhishek, primary, Shetty, A.A., additional, and Ahmed, Saif, additional
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- 2016
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11. A critical analysis of the paper – Single-step scaffold-based cartilage repair in the knee: A systematic review
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Saif Ahmed, Abhishek Vaish, and Anan A. Shetty
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030222 orthopedics ,Scaffold ,business.industry ,Single step ,030229 sport sciences ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Medicine ,Orthopedics and Sports Medicine ,business ,Cartilage repair ,Letter to the Editor ,Biomedical engineering - Published
- 2016
12. Trends in spinal cancers: Primary & metastatic. An Irish epidemiological perspective.
- Author
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O'Halloran, Amanda, McKee, Christopher, Cunniffe, Gráinne, and Morris, Seamus
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PATIENTS ,ACADEMIC medical centers ,HOSPITAL admission & discharge ,CANCER patient medical care ,BREAST tumors ,SPINAL tumors ,RETROSPECTIVE studies ,METASTASIS ,LONGITUDINAL method ,LUNG tumors ,LENGTH of stay in hospitals ,HEALTH promotion - Abstract
The incidence and histological type of spinal cancer is diverse. It is our role as physicians to explore the epidemiology of spinal cancers so that several projections can be made. Resource allocation, cost analyses, and the requirement of rehabilitation facilities all need to be considered. The objective of this paper is to provide an account of the acute spinal oncological admissions to the National Spinal Injuries Unit (NSIU) in both 2010 and 2020 with the hypothesis that upward trends will be noted. Only by exemplifying this trend, will it highlight the need to give spinal cancer the attention it deserves in the Republic of Ireland. All patients who were to undergo spinal surgery for primary or metastatic spinal cancer in the Mater Misericordiae University Hospital (MMUH) in 2010 and 2020 were included in this retrospective cohort study. A list of medical record numbers (MRNs) for all patients who underwent spinal surgery in the MMUH were included. Data pertaining to patient demographics were noted. 90 patients were included in this retrospective cohort study. 37 patients in 2010, had increased to 53 by 2020. Metastatic disease to the spine was still the most prominent reason for referral. The most common spinal region affected was the thoracic spine. Breast cancer was the most prevalent metastatic cancer to the spine in 2010. Lung cancer became the most prevalent by 2020. Posterior spinal fusion was the most frequent surgical procedure performed. The length of stay in higher care facilities decreased from 5.4 days in 2010, to 4 days in 2020. Decreased were also seen in the mean length of hospital stay, plummeting from 23.6 days in 2010, to 7.6 days in 2020. The same could not be said for the 30-day mortality rate, increasing from 5.4% in 2010, to 9.4% in 2020. The results of this study show a substantial rise in the incidence and prevalence of both primary and metastatic spinal disease here in Ireland. One can see clear improvements in operative technique, with less patients proceeding to higher levels of post-operative care, and earlier discharge times. This data can be used for future planning. The paper highlights the economic cost of spinal oncological care, but it also identifies key areas where preventative campaigns can be targeted. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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13. Top 100 most cited articles in orthopaedic surgery: An update
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Mauro Giordani, Gavin Pereira, John P. Meehan, and Zachary C. Lum
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030222 orthopedics ,medicine.medical_specialty ,Multivariate statistics ,Top 100 orthopaedic articles ,Other Medical and Health Sciences ,Web of science ,business.industry ,Clinical Sciences ,Rank (computer programming) ,Top 100 orthopaedic papers ,030229 sport sciences ,Article ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,Orthopedic surgery ,medicine ,Most referenced orthopaedic research papers ,orthopedics ,Orthopedics and Sports Medicine ,Orthopaedic research ,business ,Citation - Abstract
Introduction As the research landscape evolves, we sought to investigate the current most cited Orthopaedic Surgery articles and compare these to previously cited articles. Methods Web of Science database screened orthopaedic journal articles with comparison to previous data using multivariate regression analysis. Results Rate of citations increased 172% within the last decade. Previous rank and citations within the last decade had a greater effect on contemporary rank (p = 0.084, p = 0.002, respectively). Conclusion Trends in investigative research can shift by the next decade. Previous citation rank and citations in last decade contributed most to current rank.
- Published
- 2020
14. Comparison of outcomes of different Graf grades of developmental dysplasia of the hip in infants treated with Tubingen splint versus Pavlik harness - A systematic review.
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Nair, Ajay, Yatsonsky, David, and Liu, Jiayong
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HIP joint dislocation ,MEDICAL information storage & retrieval systems ,SPLINTS (Surgery) ,SURGERY ,PATIENTS ,ORTHOPEDIC apparatus ,TREATMENT effectiveness ,DYSPLASIA ,ORTHOPEDIC surgery ,SYSTEMATIC reviews ,MEDLINE ,SURGICAL complications ,COMPARATIVE studies ,ONLINE information services ,OSTEONECROSIS ,DISEASE incidence ,EVALUATION ,CHILDREN - Abstract
This systematic review was designed to compare the outcomes of the two braces against each other classified by the Graf method. The databases sources included PubMed, Embase, and Google Scholar. The keywords included "DDH Tubingen versus Pavlik" and Tubingen and Pavlik separately. Included papers provided specific data regarding success and failure rate, avascular necrosis (AVN), duration, and age of intervention. The excluded studies discussed surgeries, diagnosis and mechanism, and ones that weren't in English. Total of 20 papers were included, resulting in 1243 Tubingen and 420 Pavlik samples. It was seen that the Tubingen splint had a statistically significant greater success rate and lower failure rate for Graf 2, D, and 3 hips, while both braces were not very successful for Graf 4 at success rates less than 60 %. Tubingen also had a lower incidence of AVN. Both braces shared similar ages of intervention, duration, and time per day. Both braces are very comparable to each other, each having better success rates for lower Graf grades, which points to the importance of bracing earlier to improve the success rates. The Tubingen splint had a higher success rate, lower failure rate, and lower AVN rate compared to the Pavlik harness. This points to the Tubingen splint potentially being the preferred option for bracing in infants. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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15. Machine Learning assisted systematic reviewing in orthopaedics.
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Pijls, Bart G.
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SYSTEMATIC reviews ,ORTHOPEDICS ,INFORMATION retrieval ,LITERATURE reviews ,MEMORY ,MACHINE learning ,CONFIDENCE intervals ,EVALUATION - Abstract
Machine learning assisted systematic reviewing may help to reduce the work burden in systematic reviews. The aim of this study is therefore to determine by a non-developer the performance of machine learning assisted systematic reviewing on previously published orthopaedic reviews in retrieving relevant papers. Active learning for Systematic Reviews (ASReview) was tested against the results from three previously published systematic reviews in the field of orthopaedics with 20 iterations for each review. The reviews covered easy, intermediate and advanced scenarios. The outcomes of interest were the percentage work saved at 95% recall (WSS@95), the percentage work saved at 100% recall (WSS@100) and the percentage of relevant references identified after having screened the first 10% of the records (RRF@10). Means and corresponding [95% confidence intervals] were calculated. The WSS@95 was respectively 72 [71–74], 72 [72–73] and 50 [50–51] for the easy, intermediate and advanced scenarios. The WSS@100 was respectively 72 [71–73], 62 [61–63] and 37 [36–38] for the easy, intermediate and advanced scenarios. The RRF@10 was respectively 79 [78–81], 70 [69–71] and 58 [56–60] for the easy, intermediate and advanced scenarios. Machine learning assisted systematic reviewing was efficient in retrieving relevant papers for systematic review in orthopaedics. The majority of relevant papers were identified after screening only 10% of the papers. All relevant papers were identified after screening 30%–40% of the total papers meaning that 60%–70% of the work can potentially be saved. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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16. Biomechanical considerations for strategies to improve outcomes following volar plating of distal radius fractures.
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Ramavath, A., Howard, N., and Lipscombe, S.
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BIOMECHANICS ,BONE screws ,FRACTURE fixation ,BONE fractures ,MEDICAL information storage & retrieval systems ,INTERNAL fixation in fractures ,MEDLINE ,ONLINE information services ,RADIUS bone injuries ,SYSTEMATIC reviews ,TREATMENT effectiveness - Abstract
This article is a systematic review of the recent published literature on the biomechanics of volar locking plate fixation of distal radius fractures. PUBMED/MEDLINE and EMBASE databases were searched on 13th Sep 2018. Biomechanical papers on volar locking plate fixation of distal radius fractures since 2010 were included. Papers were analysed and included studies were appraised by the author using the validated quality assessment GRADE tool. The search revealed 456 papers between January 2010 and the present day whose abstracts were reviewed for relevance and 21 papers were included for full paper review. The aim of this systematic review was to evaluate the evidence to determine the surgical techniques and strategies that are associated with the best biomechanical outcomes of volar plating for distal radius fractures. Review of the literature revealed that it was not necessary to fill all available distal locking screws, there was little evidence to support the use of 2 rows of screws distally over 1 row. Screws of 75% length of the distal cortex are sufficient to withstand standard postoperative regimes in extrarticular fractures. The was a paucity of evidence to conclude multidirectional locking plates were superior to fixed angle plates or that one brand of plate was superior to another. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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17. Gastrocnemius recession: Discrepancies in the literature.
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Ehrenborg, Nicholas, Davis, Connor, Tremoulis, Jacob, Bussert, Brett R., Cheney, Nicholas A., and O'Connor, Patrick M.
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TERMS & phrases ,MEDICAL technology ,CALF muscles ,SURGICAL complications - Abstract
A gastrocnemius contracture is a common problem that results in decreased ankle dorsiflexion that contributes to an array of foot and ankle ailments. A common surgical treatment for this condition is a gastrocnemius recession (GR). Many adaptations of the original procedure have been described. Misinterpretations of proper GR procedures have potentially caused confusion when selecting a treatment. This paper proposes to identify errors between the use of GR and gastrocnemius-soleus recession (GSR) procedure techniques in the current literature. A systematic literature review was performed in June 2021, using the PubMed database and select orthopedic texts. Only studies that met the established criteria and either correctly or incorrectly described a GR or GSR procedure were included. After applying exclusion criteria, 108 publications were included. These articles and texts were reviewed for surgical technique and terminology errors in accordance with established parameters. The articles were classified as either: "Correct" or "Incorrect." Of the 108 publications and texts included, 18 articles incorrectly described either a GR or a GSR (16.67%). Ninety articles correctly described either a GR or a GSR (83.33%). The literature supports the use of a GR to treat a gastrocnemius contracture. Inaccurate articles create confusion as to what exactly a GR entails. Sources of ambiguity included terminology, inconsistent anatomical zone definition, and technique selection. Due to this confusion, it is suspected that patient outcomes can be impacted. Postoperative outcomes of GSR patients are worse than GR patients. Further investigation is necessary to determine if performing the incorrect procedure negatively affects patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Future directions for early detection of fracture related infections.
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Tay, Hui Wen and Tay, Kae Sian
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DIAGNOSTIC imaging ,PLATELET count ,GENOMICS ,GUT microbiome ,BONE fractures ,SURGICAL complications ,CALCIUM ,SURGICAL site infections ,EARLY diagnosis ,CYTOKINES ,INFLAMMATION ,BIOMARKERS ,MOLECULAR diagnosis - Abstract
Fracture related infection (FRI) refers to pathogens infecting a fracture site and hence impeding fracture healing. It is a significant complication that carries substantial disease burden and socio-economic costs, but has had limited scientific development. Hence, this paper will review the existing strategies for early detection of FRI, in the form of serum markers, molecular diagnostics and imaging modalities, and further discuss potential future directions for improved detection of FRI. The Anti-infection Global Expert Committee (AIGEC) developed a consensus definition for FRI in 2017, which includes confirmatory and suggestive criteria for diagnosis of FRI. Existing strategies for diagnosis include clinical, laboratory, histopathological, microbiological and radiological investigations. With increasing recognition of FRI, early detection is crucial for early treatment to be enforced. We have identified potential areas for future development in diagnostics for early detection of FRI, which are discussed in this manuscript. They include inflammatory cytokines, serum calcium levels, platelet count, improved management of histopathological and microbiological specimens, metagenomics, wound biomarkers, gut microbiota analysis, and novel imaging technologies. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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19. A systematic review of the use of shockwave therapy for knee osteoarthritis.
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Liao, Po-Cheng, Chou, Shih-Hsiang, and Shih, Chia-Lung
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THERAPEUTIC use of hyaluronic acid ,KNEE osteoarthritis ,MEDICAL information storage & retrieval systems ,PROSTACYCLIN ,ADRENOCORTICAL hormones ,PHYSICAL therapy ,DIPHOSPHONATES ,EXERCISE therapy ,TREATMENT effectiveness ,PLATELET-rich plasma ,SYSTEMATIC reviews ,MEDLINE ,STRENGTH training ,INTRAVENOUS therapy ,MEDICAL databases ,ULTRASONIC therapy ,ONLINE information services ,INTRAVENOUS injections - Abstract
Previous studies assessed the effect of extracorporeal shockwave therapy (ESWT) for knee osteoarthritis (OA) among different situations. Thus, results from a meta-analysis regarding this topic may not be reliable due to heterogeneity. A systematic review was conducted on three internet databases, namely Cochrane Library, PubMed, and Embase, gathering pertinent papers from their establishment to March 2024. The search phrases were as follows: "shockwave" OR "shock wave" OR "extracorporeal shockwave" OR "Extracorporeal Shockwave Therapy [MeSH Term]" AND "knee" AND ("osteoarthritis" OR "arthritis" OR "arthritic" OR "osteoarthritis [MeSH term]"). Twenty-four articles (n = 888) were included, with the resulting conclusions demonstrating that ESWT was effective for knee OA compared with sham ESWT; however, ESWT was not effective for patients with severe knee OA. Patients receiving higher energy or higher shock number had significant improvement than those receiving lower energy or less shock number, respectively. Adding ESWT in isokinetic muscular strengthening exercises (IMSE) was more effective than IMSE alone. The efficacy of ESWT was better than other therapies, including intravenously applied prostacyclin and bisphosphonate, corticosteroid injection, kinesiotherapy, hyaluronic acid injection, platelet-rich plasma injection, and physiotherapy. This review demonstrated that ESWT was effective for knee OA. Higher energy and more shock numbers could obtain better efficacy. ESWT could be used as a replacement for some other therapies. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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20. Funding has no effect on studies evaluating viscosupplementation for knee osteoarthritis: A systematic review of bibliometrics and conflicts of interest.
- Author
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Via, Garrhett Glenn, Brueggeman, David Anthony, Lyons, Joseph Gabriel, Frommeyer, Timothy Charles, Froehle, Andrew William, and Krishnamurthy, Anil Bangalore
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KNEE osteoarthritis ,ONLINE information services ,META-analysis ,CONFIDENCE intervals ,SYSTEMATIC reviews ,HYALURONIC acid ,RESEARCH ethics ,CONFLICT of interests ,ENDOWMENT of research ,INTRA-articular injections ,DESCRIPTIVE statistics ,CHI-squared test ,DECISION making ,MEDLINE ,MEDICAL research - Abstract
Viscosupplementation for knee osteoarthritis (OA) may raise concerns regarding conflicts of interest (COI). Evidence of inconclusive study results and publication bias in previous studies has led to concern that financial COI have influenced viscosupplementation outcomes. It is critical to ensure that clinical practice is guided by informed decision making and evidence-based medicine. A systematic review was conducted following PRISMA guidelines. PubMed, MEDLINE, and Web of Science databases were searched for articles pertaining to hyaluronic acid (or similarly derived) injections to native knees with primary OA only. Bibliometric data, financial COI, and study outcomes were assessed. 67 studies met inclusion criteria for analysis, 53 of which (79.1%) presented Level I evidence, and 21 of which (31.3%) reported at least one author with COI. All studies reporting COI also disclosed industry funding. There were no relationships between reported COI and study outcomes (Χ
2 = 0.31, P = 0.577), levels of evidence (Χ2 = 3.48, P = 0.176), or relative citation ratio (RCR) (S = 743, P = 0.591). Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors (IF) (reporting COI: IF = 3.5 ± 2.0; no COI: IF = 1.8 ± 1.1; S = 950, P < 0.001). Study outcomes were not related to the probability of being published in an open access journal (Χ2 = 0.01, P = 0.960), nor to level of evidence (Χ2 = 2.67, P = 0.263), RCR (S = 618, P = 0.835), or IF (S = 563, P = 0.655). Investigator COIs (and commercial funding of studies) have not significantly influenced the frequency of favorable outcomes or study level of evidence regarding contemporary viscosupplementation for the treatment of knee OA. Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors. Results overwhelmingly supported using viscosupplementation to treat knee OA. Level V Systematic Review. • Viscosupplementation may represent a promising treatment modality for knee osteoarthritis. • Wide variation in reported efficacy necessitates further analysis for sources of bias. • Author conflicts and industry funding had no significant effect on study results or conclusions. • Conflicted papers had higher impact factors, yet similar evidence level and relative citation ratio to non-conflicted papers. • Most papers reported favorable outcomes regardless of presence of industry funding. [ABSTRACT FROM AUTHOR]- Published
- 2023
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21. A single centre experience of pre-contoured clavicle plates by an anterior approach
- Author
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Fahey, Eoin.J., Galbraith, John.G., and Kaar, Ken
- Published
- 2019
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22. Articulated lengthening fixation apparatus (ALFA) for the management of gap non-union of distal femur: Initial experience on a new technique.
- Author
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Vardhan, Sunit, Regmi, Anil, Niraula, Bishwa Bandhu, Kunwar, Bom Bahadur, Olkha, Vikas, and Dhingra, Mohit
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FEMORAL fractures ,BONE regeneration ,FRACTURE fixation ,TREATMENT effectiveness ,FUNCTIONAL status ,DESCRIPTIVE statistics ,SURGICAL complications ,BONE lengthening (Orthopedics) ,SURGICAL instruments ,UNUNITED fractures ,RANGE of motion of joints - Abstract
Distal femur non-union is difficult to deal with because of limited or no bone stock left for holding pins. Also, knee range of motion is a major concern in case of distal femur non-union to deal with. ALFA is a new modality of definitive external fixator with limited literatures. This paper aims to present the series of cases of gap non-union of the distal femur managed with an ALFA fixator and their outcome as an initial experience on a new device. Eight patients of gap non-union distal femurs where the ALFA fixator application was done between January 2022 to June 2022 were evaluated. Patients with intra-operative bone gap <5 cm were acutely docked and >5 cm were left as it is as a bon gap and gradual distraction was done to achieve bone gap length and limb length discrepancy. Patients were assessed for functional, radiological, and clinical outcomes, at the time of surgery, completion of distraction, and completion of consolidation. The scores from our study were compared with the Ilizarov and mono-lateral fixator with the available data. Eight patients managed with ALFA fixator had mean age of 32.12 ± 6.82 years. The mean limb length discrepancy at the time of operation was 5.25 ± 3.11 cm, with Intra-operative bone gap of 4.68 ± 3.47 cm where 5 patients managed with acute docking and 3 patient managed with leaving the bone-gap. The mean regenerate gained after distraction was 9 ± 4.63 cm at the mean distraction duration of 113.37 ± 67.34 days. The mean time of removal of the fixator (n = 5), was 203 ± 111 days, and the mean external fixator index, days/cm (n = 5) was 34 days/cm. The number of complications per patient was 0.25 per patient. The Mean residual LLD was, 0.43 ± 0.58, with significant improvement of Limb Length compared to pre-operative LLD with a p-value of 0.0014. ALFA fixator for gap non-union as an alternative to Ilizarov, and LRS provides adequate distraction osteogenesis, less neurovascular complication due to pins, better patient tolerability, and user-friendly distraction of the distal femur with preserved knee range of motion. III. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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23. Tribo-corrosive behavior of additive manufactured parts for orthopaedic applications.
- Author
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Malik, Abrar, Rouf, Saquib, Ul Haq, Mir Irfan, Raina, Ankush, Valerga Puerta, Ana Pilar, Sagbas, Binnur, and Ruggiero, Alessandro
- Subjects
PROSTHETICS ,SYNOVIAL membranes ,RHEOLOGY ,PRODUCT design ,FRICTION ,MATERIALS testing ,SURFACE properties ,THREE-dimensional printing ,NEW product development ,ORTHOPEDIC apparatus - Abstract
Additive manufacturing (AM) being an integral component of the production offers a wide variety of applications in the production of different components. The medical industry after the introduction of Additive Manufacturing has resulted in several advancements. The production of intricate patient-specific implants is one of such advancements which greatly assist a surgeon during a surgery. Orthopedic implants apart from possessing good mechanical strength are also expected to exhibit good tribological and corrosion behavior. As a result, the development of various orthopaedic implants and tools has become simple with the use of additive manufacturing. In the current paper an effort has been made to discuss actual scientific knowledge on the tribo-corrosive behavior of additive manufactured parts for orthopedic applications. Different studies dealing with the mechanisms of lubrication and friction in synovial joints have also been considered. A special focus has also been laid down to study the corrosive effect of implants on the human body. A section dedicated to texturing of orthopedic implants has also been provided. The paper further elaborates the different research challenges and issues related to the use of additive manufacturing for the production of optimized orthopedic implants. The study revealed that additive manufacturing has greatly aided in the manufacture of different orthopaedic implants with enhanced properties. However, a detailed study of the effect of processes like friction, wear, lubrication and corrosion in these implants needs to be done. The performance of these implants in the presence of various synovial fluids also needs to be addressed. However, the lack of more biocompatible materials, scalability and cost issues hinder the widespread use of AM in the different orthopaedic applications. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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24. Management of gunshot wound-related hip injuries: A systematic review of the current literature.
- Author
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Tisnovsky, Ilene, Katz, Simon D., Pincay, Jorge I., Garcia Reinoso, Lucas, Redfern, James A.I., Pascal, Scott C., Wham, Bradley C., Naziri, Qais, and Suneja, Nishant
- Subjects
ANTIBIOTICS ,GUNSHOT wounds ,SYSTEMATIC reviews ,HIP joint injuries - Abstract
To propose a gunshot wound-related hip injury algorithm and improve patient outcomes. Multiple online databases were queried to identify studies reporting on management of gunshot-wound hip injury. Of 47 papers included, 5 and 14 studies recommended surgical intervention for the treatment of low- and high-velocity gunshot wounds, respectively, and 1 paper advocated the use of prophylactic antibiotics in the treatment of high-velocity injuries. All remaining papers had mixed and conflicting results. Various therapeutic strategies have been used for the management of gunshot wound-related hip injuries but further prospective studies are necessary to determine the optimal therapeutic modality. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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25. Variations in common operations in athletes and non-Athletes.
- Author
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Joshi, Amit, Basukala, Bibek, Singh, Nagmani, Panta, Sunil, Sharma, Rajiv, and Pradhan, Ishor
- Subjects
POSTERIOR cruciate ligament surgery ,ONLINE information services ,OPERATIVE surgery ,FUNCTIONAL status ,SYSTEMATIC reviews ,SHOULDER injuries ,JOINT instability ,ATHLETES ,TREATMENT effectiveness ,SEARCH engines ,ANTERIOR cruciate ligament surgery ,MEDLINE ,MENISCUS injuries - Abstract
Achieving pre-injury activity level after an injury is the fundamental goal of any orthopedic treatment for an athlete. Unfortunately, pre-injury activity levels differ significantly in different patient categories, especially in athletes and non-athlete. Hence, an outcome suitable to a non-athlete may not be adequate for an athlete. This has led to variations in the surgical approach to the same injury in an athlete and non-athlete. There is plenty of literature published comparing the outcome in athletes and non-athletes after a particular surgery. Scattered discussion about variations in these surgeries based on functional demand was done in many publications. But there was a lack of a comprehensive narrative review summarizing variations in common operations among athletes and non-athletes. This review attempted to summarize variations in common sports operations between high functional demand patients and low demand patients and discuss the variations from the author's perspective. A review of all the relevant papers were conducted focusing on athletes and non-athletes. Most commonly performed sports surgeries were ACL reconstruction, Meniscal repair, PCL reconstruction, and Shoulder instability surgery. A literature search was done for each commonly performed surgery using relevant keywords in PubMed and Google Scholars. Summary of papers pertinent to athletes and non-athletes were compiled to prepare this narrative review. There is a lack of papers directly comparing results in athletes and non-athletes. However, many research papers discussed surgical variations in athletes (high demand) and non-athletes (low demand) patients. There are controversies in all commonly performed surgeries, and none of the papers gives a definitive guideline on the approach to athletes and non-athlete. Rather than a common suggestion on surgical variation, an individualized approach would be appropriate to decide on variation in particular surgery in both athletes and non-athletes. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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26. IS (Idiopathic Scoliosis) etiology: Multifactorial genetic research continues. A systematic review 1950 to 2017.
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Maqsood, Ayesha, Frome, David K., Gibly, Romie F., Larson, Jill E., Patel, Neeraj M., and Sarwark, John F.
- Subjects
COMPARATIVE studies ,GENOMES ,MEDLINE ,ONLINE information services ,SCOLIOSIS ,SPINE ,SYSTEMATIC reviews ,ADOLESCENT idiopathic scoliosis - Abstract
IS (idiopathic scoliosis) is a common spinal condition occurring in otherwise completely healthy adolescents. The root cause of IS remains unclear. This systematic review will focus on an update of genetic factors and IS etiology. Though it is generally accepted that the condition is not due to a single gene effect, etiology studies continue looking for a root cause including genetic variants. Though susceptibility from multiple genetic components is plausible based on known family history data, the literature remains unclear regarding multifactorial genetic influences. The objective of this study was to critically evaluate the evidence behind genetic causes (not single gene) of IS through a systematic review and strength-of-study analysis of existing genetic and genome-wide association studies (GWAS). We used the protocol of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed was searched for the terms IS, scoliotic, spinal curve, genetic, gene, etiology, polymorphisms. Articles were assessed for risk-of-bias. Level-of-evidence grading was completed via Oxford Centre for Evidence-Based Medicine criteria. The assessment scores factor strength of a study in determining a positive or negative association to a gene etiology. After screening of 36 eligible papers, 8 relevant studies met inclusion criteria at this time, 3 were in favor of a genetic factor for IS, whereas 5 studies were against it. Based on the literature analyzed, there is moderate evidence with a low risk-of-bias that does not clarify a genetic cause of IS. The 2 studies in favor of a genetic etiology were completed in homogeneous populations, limiting their generalizability. Relying on a genetic etiology alone for IS may over simplify its multifactorial nature and limit appreciation of other influences. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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27. Experimental and finite element investigation of total ankle replacement: A review of literature and recommendations.
- Author
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Mondal, Subrata and Ghosh, Rajesh
- Subjects
ARTIFICIAL joints ,FINITE element method ,TOTAL ankle replacement - Abstract
This paper briefly reviews the different methodology, technology, challenges, and outcomes of various studies related to TAR prosthesis based on numerical and experimental techniques. Very less in-vitro experimental studies on TAR have been found than finite element (FE) studies. Due to the invasive nature of the experimental approach, inadequacy and less clinical information, computational modelling has been widely used by the researchers. This paper critically examines the part related to FE modelling and experimental analysis. Some recommendation related to modelling of bones, cartilages, ligaments, muscles, and implant-bone interface condition were discussed for better understanding the results and better clinical significance. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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28. Arthroplasty and global research output: A bibliometric analysis.
- Author
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O'Neill, Cathleen J., Cassar-Gheiti, Adrian J., and Harty, James A.
- Subjects
ARTHROPLASTY ,BIBLIOMETRICS ,MEDICAL research ,ORTHOPEDICS ,HEALTH outcome assessment ,SERIAL publications - Abstract
Introduction: Peer-reviewed research helps to advance many aspects of medical and surgical practice. This paper determines the main contributors tos joint arthroplasty research in terms of quantity and quality. Methods: A search of the Web of Science™ platform was conducted to identify arthroplasty articles published between 2001 and 2016. The number of articles and citations per article were analysed to assess the quantity and quality of research from individual countries. Results were standardised according to the country's populations and Gross Domestic Product (GDP). Results: In total, 43,470 arthroplasty articles were published worldwide from January 2001 through December 2016. There was a 4.5-fold increase in global output during this time period. Twenty-two countries contributed at least 1% to the total number of publications. The United States of America published the most articles (35.40%), followed by England (10.31%) and Germany (10.03%). The USA had the highest absolute number of citations (50,777). Denmark had the highest average citation per item (8.76). When number of articles was normalized to population, Switzerland ranked the highest. When adjusted by GDP, Scotland ranked highest. When standardised according to GDP per capita, the People's Republic of China rated highest. The Journal of Arthroplasty produced the highest number of publications related to arthroplasty with 10.9% of total volume. Conclusion: There has been a substantial increase in worldwide publications relating to arthroplasty. The USA has produced the largest volume whilst Denmark has produced the highest quality publications. When output was normalized according to population and GDP, Switzerland and Scotland ranked highest. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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29. Ankle arthrodesis: A long term review of the literature.
- Author
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Ferguson, Zak, Anugraha, Anoop, Janghir, Noman, and Pillai, Anand
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ANKLE surgery ,ARTHRODESIS ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,RANGE of motion of joints ,MEDLINE ,MUSCLE strength ,ONLINE information services ,HEALTH outcome assessment ,SYSTEMATIC reviews ,ACTIVITIES of daily living - Published
- 2019
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30. The effects of orthosis on thoracolumbar fracture healing: A review of the literature.
- Author
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Karimi, Mohammad
- Subjects
TREATMENT of fractures ,THORACIC vertebrae injuries ,SPINAL injury treatment ,LUMBAR vertebrae ,MEDICAL information storage & retrieval systems ,KYPHOSIS ,LIFE skills ,LONGITUDINAL method ,ORTHOPEDIC apparatus ,MEDLINE ,PAIN ,SYSTEMATIC reviews ,TREATMENT effectiveness ,RETROSPECTIVE studies ,FRACTURE healing ,WOUNDS & injuries - Abstract
Background: Various methods have been used as a conservative treatment of stable thoracolumbar fracture. Presently, it is controversial, whether the use of spinal orthoses reduces pain and deformity associated with vertebral fracture or not. Therefore, the aim of this study was to determine the effects of orthoses on vertebral fractures healing in thoracolumbar area. Materials and methods: A search was carried out on Medline, ISI web of knowledge, Google Scholar and Embasco. The keywords used included thoracolumbar fracture; brace, orthosis, and conservative treatment. Results: Twenty-one papers were selected for final analysis. The quality of the most of the papers was poor, as most of them were retrospective studies with various follow-up periods. Discussion: Based on the results of these studies, it can be concluded that subjects with a fracture of thoracolumbar achieved a high ability to return to their jobs. The use of orthosis did not influence the kyphosis angulation in subjects with stable fracture in thoracolumbar spine. The effects of orthoses would be mostly immobilization, protection and remaining. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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31. Is particulate or non-particulate steroid the determinant of periarticular injection efficacy for controlling postoperative TKR pain? Network meta-analysis.
- Author
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Chilmi, Mohammad Zaim, Sugianto, Julius Albert, Putra, Zainurrahman Kurnia, Hanum, Puri Safitri, and Ulfa, Maria
- Subjects
DRUG efficacy ,METHYLPREDNISOLONE ,COMBINATION drug therapy ,TOTAL knee replacement ,INJECTIONS ,META-analysis ,ANALGESIA ,TRIAMCINOLONE ,PREDNISOLONE ,CONFIDENCE intervals ,STEROIDS ,SYSTEMATIC reviews ,DEXAMETHASONE ,POSTOPERATIVE care ,BETAMETHASONE ,DESCRIPTIVE statistics ,POSTOPERATIVE pain ,PAIN management ,DRUG administration ,DRUG dosage ,EVALUATION - Abstract
Combining steroids for a periarticular injection (PAI) regiment has resulted in better pain control for postoperative TKR pain. Despite the available evidence, the most effective type of steroid for PAI still needs to be established. Network meta-analysis is conducted to analyze whether there is any difference in the effect of particulate compared to non-particulate periarticular steroid injection on post-TKR patients for pain control based on published literature. This study is conducted following the PRISMA guideline. In general, studies assessing the efficacy of periarticular injection analgesia added with either particulate (Triamcinolone, methylprednisolone, or prednisolone) or non-particulate (dexamethasone or betamethasone) steroid compared to the same regiment were analyzed. Ten studies were finally included from the 108 identified papers through database searching. VAS reduction on POD1 is found to be similar in particulate (0,91; CI95%: 0,45-1,37) compared to non-particulate (0,81; CI95%: 0,34-1,28) (Fig. 2). The difference becomes wider and favors non-particulate POD3. Subgroup analysis based on each steroid type was conducted. A stark difference can be observed for each pair of steroids (particulate and non-particulate), resulting in a similar cumulative effect of particulate and non-particulate steroids and inconsistent result on POD1 compared to POD3. From the available evidence, we concluded that particulate or non-particulate steroid does not significantly affect post-TKR pain management. Instead, the specific type of steroid contributes more to postoperative VAS reduction. Level III. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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32. Augmented and virtual reality in spine surgery.
- Author
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Luca, Andrea and Giorgino, Riccardo
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SPINAL surgery ,COMPUTER-assisted surgery ,AUGMENTED reality ,VIRTUAL reality ,ACTIVITIES of daily living ,WORKFLOW ,QUALITY assurance ,INTEGRATED health care delivery - Abstract
Augmented Reality (AR) and Virtual Reality (VR) have developed unprecedentedly in recent years, providing interesting opportunities for medical applications. Their integration into clinical assessment, surgical workflow, and training has shown tremendous potential to improve daily life activity in spine surgery. The paper explores the utilization of VR and AR in spine surgery, with their applications, benefits, challenges, and forthcoming prospects. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
33. Femoral neck stress fracture return to activity and the effect of metabolic dysfunction on recovery: A systematic review.
- Author
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Yang, Kristine, Sambandam, Senthil, Yan, Matthew J., and Huo, Michael
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MEDICAL information storage & retrieval systems ,CONVALESCENCE ,SYSTEMATIC reviews ,MAGNETIC resonance imaging ,STRESS fractures (Orthopedics) ,METABOLIC disorders ,MEDLINE ,FEMORAL neck fractures - Abstract
Femoral neck stress fractures are rare fractures traditionally found in athletes and military personnel. There is limited literature on return to activity. To report return to activity rates and times, and long-term outcomes for femoral neck stress fractures reported in the literature. To examine the effects of bone metabolic dysfunction and surgical management on return to activity following FNSF. A systematic literature review of case reports and case series on adults with femoral neck stress fracture that were diagnosed by gross fracture line on X-ray or gold-standard diagnosis with MRI was conducted. Initial search was limited to articles published from January 1997 to Jan 2023 listed in Medline, Embase, and Scopus. Additional articles were manually added via search of retained paper sources. Patient demographics, fracture type, return to activity time, and surgical vs non-surgical treatment modality were collected. In addition, long-term outcomes and metabolic effects, if reported, were abstracted. A total of 40 case reports or case series were retained. 123 stress fractures of the femoral neck from 103 patients were compiled. Of the 103 patients, data on return to activity at least one year following treatment was available for 53 patients. 71% (37/53) of those with long-term follow-up information returned to full pre-injury activity. 24% (13/53) at long-term follow-up had functional recovery but did not return to pre-injury activity due to residual pain. 4% (3/53) had disabling pain. Metabolic workup information was available for 36 patients. Long-term follow-up and return to activity information following FNSF treatment are not commonly reported. Based on the available data, outcomes appear benign with most returning to full activity. There is a clear need for standardization of follow-up periods and hip function measure after FNSF treatment. Additionally, a sizable proportion of FNSF occurred in a new population of low-activity individuals with abnormal bone metabolism, which warrants further exploration. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
34. Influential literature regarding proximal junctional kyphosis: A bibliometric review.
- Author
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Donato, Zachary, Lizardi, Juan, Constantinescu, David, Moore, Maya, and Kuczmarski, Alexander
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BIBLIOMETRICS ,SPINAL fusion ,SERIAL publications ,SURGICAL complications ,KYPHOSIS ,RISK assessment ,TREATMENT effectiveness ,HEALTH ,INFORMATION resources ,DISEASE risk factors - Abstract
Retrospective review. This bibliometric review summarizes the publication trends and critical information about the most cited Proximal Junction Kyphosis (PJK) articles. Data: Proximal junctional kyphosis is frequently diagnosed after spinal fusion surgery. However, there continues to be heavy debate regarding the definition, incidence, risk factors, and treatment of this disorder. Nine hundred eleven articles were found when searching The Web of Science database with the keywords "Proximal junctional kyphosis" and "proximal junctional failure." The 200 top-cited articles were reviewed and screened to ensure PJK was discussed. The articles were filtered based on the highest to lowest number of citations, and the top 50 articles were chosen. Inclusion criteria included articles that contained a discussion of PJK and outcomes after surgery. Exclusion criteria included articles without mentioning PJK, or that studied non-human subjects. The 50 most cited articles were sorted by level of evidence and their classification for analysis. The 50 most cited articles in this study were published a total of 6056 times. These articles were cited 71–413 times in the literature, with publications from 1994 to 2018. Most of the top 50 articles (64%) were published in the USA. Specifically, HSS and Washington University are the institutions with the most contributions to the publication of the most cited articles on PJK (n = 16). Lenke was the author that contributed to most publications in the top 50 articles on PJK. This study provides a framework for the most cited articles published on PJK. Most articles on this topic were in the category of clinical outcomes (36%) and were of a level of evidence III (46%). Most of the top-cited articles came from the journal Spine (68%) and were published in the USA (64%). These top-cited papers are essential to understanding this critical trending topic in spine surgery. III. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
35. Growing rods in Early Onset Scoliosis: The current scenario.
- Author
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Mehta, Jwalant S., Tognini, Martina, and Hothi, Harry
- Subjects
PROSTHETICS ,ORTHOPEDIC surgery ,ARTIFICIAL implants ,MAGNETIC resonance imaging ,TREATMENT effectiveness ,SCOLIOSIS ,AGE factors in disease - Abstract
The treatment of early onset scoliosis is a challenge. Some curves resolve spontaneously, while the more aggressive ones require surgical intervention. Several surgical strategies have been explored in this unique group of patients, though the distraction based growing rods are the mainstay of treatment. The aim of this paper is to consider the current scenario with the surgical treatment for early onset scoliosis with growing rods. This is a narrative review that explores the various types of growing rod options that are currently available. The results, as reported in literature, are discussed. The complications and problems with the commonly used growing rods are explored, based on the reported literature and on retrieval analysis that we have published. We discuss some of the newer modifications of growing rods. There is no real consensus on the ideal timing for the surgery or ways to assess the outcomes of the treatment. The Cobb angle measurement and measures of thoracic growth are surrogate markers. The main indication for surgery is to an increase in the thoracic dimensions and allowing for lung growth. Measures that are linked to lung function are more useful. We report some newer MRI scanning technology. Distraction-based growing rods have been reported to produce consistent and good results. Frequent return to theatre with the Traditional Growing Rods (TGR) and the metallosis related problems with the MCGR are reported. We have learned a lot from the TGR and MCGR experiences. There is a scope for ongoing research to improve the design of the implant systems and better assess the outcomes on lung function. This review outlines these and helps identify the future trends. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
36. Chronicling the effect of COVID-19 on orthopedic literature.
- Author
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Liu, Ivan Z., Wang, Kevin Y., Robin, Joseph X., McGeary, Ian, Hemal, Kshipra, and Boyd, Carter J.
- Subjects
PROFESSIONAL peer review ,KRUSKAL-Wallis Test ,ORTHOPEDIC surgery ,SERIAL publications ,PEARSON correlation (Statistics) ,CHI-squared test ,COVID-19 pandemic ,MEDICAL literature - Abstract
The novel coronavirus disease (COVID-19) has had a significant impact on orthopedic surgery practice, but there has been little investigation of the effects of COVID-19 on the orthopedic surgery literature. Additionally, because orthopedic research plays a vital role in physician education, changes to the characteristics and content of published literature can have lasting impacts on future teaching and learning. This paper represents the first known analysis of the COVID-19 pandemic's impact on peer-reviewed articles published in orthopedic surgery journals. The 20 orthopedic journals with the highest impact factors in 2019, according to the Journal Citation Reports , were included in this study. Using PubMed and COVID-19 related keywords as well as manual screening, a final count of 199 articles were assessed for this study and subsequently sorted by country of origin, orthopedic subspecialty, article type, and general theme. Kruskal Wallis and Pearson's Chi-squared tests were used to analyze continuous and categorical variables, respectively. Fourteen journals published articles relating to COVID-19, representing 26 countries with the United States (37%) and United Kingdom (13%) publishing the greatest proportion of all COVID-19 articles. Sixty percent of publications discussed COVID-19's impact on the overall field of orthopedic surgery, with the remainder focusing on specific subspecialties. Forty-seven percent of publications were original research articles while 46% were editorials or commentaries. The median time to publication for all COVID-19 related articles was 24.5 days, compared to the 129 days reported for orthopedic journals prior to the COVID-19 pandemic (p < 0.001). In the first 100 articles published, 49% (n = 49) originated exclusively from United States institutions, whereas only 25% (n = 25) of the next ninety-nine articles had US-only institutions (p < 0.001). The COVID-19 pandemic has significantly impacted the characteristics, content, and time to publication of the orthopedic surgery literature. The data and ideas presented in this paper should help streamline future, formal analysis on the lasting implications of COVID-19 on orthopedic surgery practice, teaching, and learning. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
37. Healing of femoral fractures by the meaning of an innovative intramedullary nail.
- Author
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Filardi, V.
- Subjects
TREATMENT of fractures ,FEMUR ,FRACTURE fixation ,FRACTURE healing - Abstract
In this paper, an innovative design of nail, conceived to heal fractures of long bones has been investigated. Its functioning is based essentially on sliding of conical surfaces located in a spindle and in a series of holding pins radially disposed around it. Spindle and holding pins are connected together by means of a sleeve. Medial and distal screws are not necessary. Rotational and longitudinal motions of the spindle are transformed in a radial expansion of the holding pins by the sliding of conical surfaces. A complete numerical FE model of an implanted femur was realized and analyzed by the mean of two loading configurations: LC1 by imposing a vertical load of 980 N, and LC2 by considering resultants of the muscle actions. Analyses confirmed results, in terms of mechanical performances, comparable with the others traditional systems of prosthesis. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
38. Return to sport and active military duty after cervical disc arthroplasty: A systematic review.
- Author
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Reiter, Charles R., Nelson, Chase T., Satalich, James R., O'Neill, Conor N., Cyrus, John W., O'Connell, Robert S., and Vap, Alexander R.
- Subjects
SPORTS participation ,CERVICAL vertebrae ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,ARTHROPLASTY ,SURGICAL complications ,TREATMENT failure ,REOPERATION ,EMPLOYMENT reentry ,MEDLINE ,MILITARY personnel ,DISEASE risk factors - Abstract
Cervical disc arthroplasty (CDA) has been established as an effective treatment for cervical disc degeneration or herniation in the general population. Return to sport (RTS) outcomes in athletes remain unclear. The purpose of this review was to evaluate RTS following single-level, multi-level, or hybrid CDA, with additional return to activity context provided by return to duty (RTD) outcomes in active-duty military. Medline, Embase, and Cochrane were searched through August 2022 for studies that reported RTS/RTD after CDA in athletic or active-duty populations. Data was extracted on the following topics: surgical failures/reoperations, surgical complications, RTS/RTD, and postoperative time to RTS/RTD. Thirteen papers covering 56 athletes and 323 active-duty members were included. Athletes were 59% male with a mean age of 39.8 years and active-duty members were 84% male with a mean age of 40.9 years. Only 1 of 151 cases required reoperation and only 6 instances of surgical complications were reported. Classified as return to general sporting activity, RTS was observed in 100% of patients (n = 51/51) after an average of 10.1 weeks to training and 30.5 weeks to competition. RTD was observed in 88% of patients (n = 268/304) after an average of 11.1 weeks. Average follow-up was 53.1 months for athletes and 13.4 months for the active-duty population. CDA displays excellent RTS and RTD rates in physically demanding populations at rates superior or equivalent to alternative treatments. Surgeons should consider these findings when determining the optimal cervical disc treatment approach in active patients. • Systematic review identified 13 studies with 56 athletes and 323 active-duty service members with cervical disc arthroplasty. • Only 1 of 151 reported cases required reoperation and 6 of these reported surgical complications. • Return to Sport (RTS) observed in 100% of athletes (n=51/51); Return to Duty (RTD) observed in 88% of military (n=268/304). [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. The fifty most-cited articles regarding midshaft clavicle fractures.
- Author
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Tandron, Marissa, Cohen, Lara, Cohen, Jacob, Allegra, Paul, Munoz, Julianne, Kaplan, Lee, and Baraga, Michael
- Subjects
BONE shafts ,CONFIDENCE intervals ,CLAVICLE fractures ,SYSTEMATIC reviews ,ONE-way analysis of variance ,DESCRIPTIVE statistics - Abstract
The clavicle is the most frequently fractured bone in the human body, and up to 80% of clavicle fractures occur in the middle third diaphyseal region of the clavicle (midshaft). We conducted a bibliometric analysis to identify and evaluate the 50 most-cited publications pertaining to midshaft clavicle fractures (MCF). Two independent reviewers conducted separate queries on Web of Science in December 2021 for "midshaft clavicle fractures". The publications yielded were organized from highest to lowest number of citations. We included articles, review articles, and editorial materials and excluded other document types. Both reviewers independently reviewed all abstracts until 50 studies pertaining to MCF were included. We hypothesized that most articles would be published between 2000 and 2019, pertain to outcomes, and those with a greater (lower numeric) level of evidence would correlate with number of citations. The most prolific decade was from 2010 to 2019, with 50% (25/50) of articles published. Average citation density was 6.3 ± 5.5 (range, 1.3–33.1), defined as the average number of citations per year since publication. The median level of evidence (LOE) was 3.5 (IQR: 3). One-way ANOVA tests were used to compare the effects of LOE on total citations and citation density. There were statistically significant differences in total citations (F value = 12.07, p = 0.001) and citation density (F value = 21.14, p < 0.001) between LOE groups. The median number of total citations, grouped by LOE of 1 through 5, were as follows: 110, 66, 66, 51, 52. This review provides an overview of the 50 most cited papers regarding MCF. This should be used as a reference for physicians and other providers who treat patients with MCF for treatment guidance and for those in teaching roles as a student and resident/fellow educational resource. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
40. Review: Trunnionosis leading to modular femoral head dissociation.
- Author
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Dutta, Agneish, Nutt, James, Slater, Guy, and Ahmed, Syed
- Subjects
TOTAL hip replacement ,FEMUR head ,SURGICAL complications ,REOPERATION ,COMPLICATIONS of prosthesis - Abstract
Component dissociation secondary to trunnionosis is rare, and its causes are multifactorial. It is a major complication of total hip replacement, in most cases requiring revision arthroplasty. In this paper, we present a case of taper/head modular interface dissociation in a metal-on-metal total hip replacement. We review the literature of both trunnionosis, as well as a systematic review of modular dissociation of the femoral component in total hip arthroplasty, identifying commonalities with our own case. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
41. Techniques for lower trapezius tendon transfer for the management of irreparable posterosuperior rotator cuff tears.
- Author
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Ghoraishian, Mohammad, Stone, Michael A., Elhassan, Bassem, Abboud, Joseph, and Namdari, Surena
- Subjects
ACHILLES tendon ,ARTHROSCOPY ,ADDUCTION ,ORTHOPEDIC surgery ,OSTEOTOMY ,SHOULDER joint ,ROTATOR cuff injuries ,TREATMENT effectiveness - Abstract
Irreparable posterosuperior rotator cuff tears are a challenging treatment problem. Several tendon transfers have been described for the treatment of irreparable tears. Recently the lower trapezius (LT) tendon transfer has grown in popularity. This procedure has shown promise in biomechanical studies, improving the external rotation moment arm at the side. This transfer may be done in several ways, including an open approach with an acromial osteotomy, mini-open, and arthroscopic-assisted. The purpose of this paper is to review the current evidence and rationale for the use of the LT transfer and to describe the available techniques. • The LT transfer improves external rotation in the adducted position. • TMay be performed via open approach (acromial osteotomy), mini-open, or arthroscopic-assisted. • Accessory nerve most at risk with dissection 2 cm medial to the medial scapular border. • Achilles tendon allograft commonly used [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
42. The epidemiology of thoracolumbar trauma: A meta-analysis.
- Author
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Yoshihiro Katsuura, Osborn, James Michael, and Cason, Garrick Wayne
- Abstract
Purpose: To describe the epidemiology of thoracolumbar fractures and associated injuries in blunt trauma patients. Methods: A systematic review and metaanalysis was performed based on a MEDLINE database search using MeSH terms for studies matching our inclusion criteria. The search yielded 21 full-length articles, each sub-grouped according to content. Data extraction and multiple analyses were performed on descriptive data. Results: The rate of thoracolumbar fracture in blunt trauma patients was 6.90% (±3.77,95% CI). The rate of spinal cord injury was 26.56% (±10.70), and non-contiguous cervical spine fracture occurred in 10.49% (±4.17). Associated injury was as follows: abdominal trauma 7.63% (±9.74), thoracic trauma 22.64% (±13.94), pelvic trauma 9.39% (±6.45), extremity trauma 18.26% (±5.95), and head trauma 12.96% (±2.01). Studies that included cervical spine fracture with thoracolumbar fracture had the following rates of associated trauma: 3.78% (±5.94) abdominal trauma, 21.65% (±16.79) thoracic trauma, 3.62% (±1.07) pelvic trauma, 18.36% (±4.94) extremity trauma, and 15.45% (±11.70) head trauma. A subgroup of flexion distraction injuries showed an associated intra-abdominal injury rate of 38.70% (±13.30). The most common vertebra injured was L1 at a rate of 34.40% (±15.90). T7 was the most common non-junctional vertebra injured at 3.90% (±1.09). Burst/AO type A3 fractures were the most common morphology 39.50% (±16.30) followed by 33.60% (±15.10) compression/AO type A1, 14.20% (±8.08) fracture dislocation/AO type C, and 6.96% (±3.50) flexion distraction/AO type B. The most common etiology for a thoracolumbar fracture was motor vehicle collision 36.70% (±5.35), followed by high-energy fall 31.70% (±6.70). Conclusions: Here we report the incidence of thoracolumbar fracture in blunt trauma and the spectrum of associated injuries. To our knowledge, this paper provides the first epidemiological road map for blunt trauma thoracolumbar injuries. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
43. Injections for treatment of carpal tunnel syndrome: A narrative review of the literature.
- Author
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Cage, Emily S., Beyer, Julia J., and Ebraheim, Nabil A.
- Subjects
ONLINE information services ,CARPAL tunnel syndrome ,ADRENOCORTICAL hormones ,INJECTIONS ,SYSTEMATIC reviews ,QUALITY assurance ,DESCRIPTIVE statistics ,MEDLINE ,DISEASE management - Abstract
Carpal tunnel syndrome is an extremely common condition in the general population. Nonoperative treatment is a mainstay of management prior to surgical carpal tunnel release. Injections are frequently used as treatment, especially corticosteroid injections, but there is little consensus in the literature regarding injection number, volume, corticosteroid dose, and technique. A comprehensive literature search was performed of PubMed to identify papers relating to corticosteroid injections as well as other injections performed in patients with carpal tunnel syndrome. A total of 45 articles were selected for inclusion in this review. Corticosteroid injections for carpal tunnel syndrome are discussed in detail, including injection number, volume, and technique as well as corticosteroid dose. Alternative injections for management of carpal tunnel syndrome are also discussed. Corticosteroid injections have been identified as a safe, effective short term management option for carpal tunnel syndrome. However, there is no standardized recommendation for specifics of their use in relation to corticosteroid dose, number of injections, injectate volume, and use of ultrasound guidance. Further research is required to better establish the optimal role for corticosteroid injections in the treatment of carpal tunnel syndrome. Platelet rich plasma, lidocaine, and hyaluronic acid, among others, are additional injections that warrant further exploration for use in management of carpal tunnel syndrome. • CSIs are a safe, effective nonoperative treatment method for CTS in the short term. • Alternative injections are emerging, which include PRP, hyaluronic acid, and local anesthetics. • There exists much variability in the literature regarding the use of corticosteroid injections, including injection number, corticosteroid dose, injectate volume, and use of ultrasound guidance. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
44. Prosthetic joint infections of the shoulder: A review of the recent literature.
- Author
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Faria, Giles, Flood, Catherine, Muhammed, Abdul Rasheed, Narang, Ashish, Masood, Qazi, Bakti, Nik, and Singh, Bijayendra
- Subjects
SHOULDER joint surgery ,ANTIBIOTICS ,ONLINE information services ,DEBRIDEMENT ,SYSTEMATIC reviews ,RESPIRATORY aspiration ,RESEARCH methodology ,TISSUE culture ,ARTIFICIAL joints ,INFECTION ,MEDLINE ,PROSTHESIS-related infections ,SYNOVIAL fluid - Abstract
Shoulder arthroplasty is a common treatment for shoulder arthritis. Prosthetic joint infection of the shoulder (PJIS) is a debilitating complication to the patient and the healthcare system. Incidence of infection is 0.98–5% for primary arthroplasty. The mean hospital cost for two-stage revision was approximately $35,824. The aim of this paper is to review the recent literature and collate the latest evidence to aid diagnosis and treatment of this serious complication. A literature review was performed using PubMed and Google Scholar databases. A search strategy was adopted using the keywords: 'infection' AND 'shoulder arthroplasty' OR 'total shoulder arthroplasty'OR 'TSA' OR 'reverse shoulder arthroplasty' OR 'RSA' OR 'rTSA'. This initial search resulted in 349 articles. A PRISMA flowchart process was followed. Duplicates were removed, screening was performed and the resulting full texts were analysed and further excluded, leaving 46 articles suitable for inclusion. A PICO search strategy was also used. Risk factors for PJIS include procedure type, trauma indications and patient factors. The organism commonly isolated is Cutebacterium acnes, which makes diagnosis challenging due to its indolent nature. Investigations include biochemical tests, synovial aspirate, tissue cultures and radiological examinations. Treatment depends on the depth of the infection and the patient requirements. Medical treatment with antibiotics to local debridement, cement spacer and revision arthroplasty have all been described in the literature. A multidisciplinary decision is made on the microbiological evidence and patient factors. PJIS is a rare but potentially devastating complication of shoulder arthroplasty and diagnosis is often challenging. There has been much research performed recently, providing more evidence on how to optimise management. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
45. Is augmentation the best solution in partial anterior cruciate ligament tears? A literature systematic review and meta-analysis.
- Author
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Bosco, Francesco, Giustra, Fortunato, Crivellaro, Michele, Giai Via, Riccardo, Lavia, Alessandro Dario, Capella, Marcello, Sabatini, Luigi, Risitano, Salvatore, Rovere, Giuseppe, Massè, Alessandro, and Vaishya, Raju
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ONLINE information services ,MEDICAL databases ,META-analysis ,MEDICAL information storage & retrieval systems ,OPERATIVE surgery ,SYSTEMATIC reviews ,SURGERY ,PATIENTS ,TREATMENT effectiveness ,ANTERIOR cruciate ligament injuries ,DESCRIPTIVE statistics ,DECISION making in clinical medicine ,MEDLINE - Abstract
The appropriate management of partial anterior cruciate ligament (ACL) tears is still debated. There is a tendency in orthopedic clinical practice to prefer complete ACL reconstruction, while few surgeons perform ACL augmentation. The purpose of the present study is to evaluate the current evidence on the effectiveness of ACL augmentation compared with standard ACL reconstruction to assess whether ACL augmentation may be the treatment of choice in partial ACL injury. According to PRISMA guidelines, literature research was performed in PubMed/Medline, Cochrane Library, Embase, Scopus, and Web of Science databases. A PICOS model was used, and a preliminary search resulted in 1101 articles. The methodological quality was assessed through ROBINS-I. A meta-analysis was conducted on postoperative Tegner, Lysholm scores and KT-1000 values between ACL augmentation and ACL reconstruction, and a p < 0.05 has been assumed as statistically significant. PROSPERO, ID: CRD42022343502. Seven papers were included. A total of 472 knees underwent ACL reconstruction, and 311 underwent ACL augmentation. A statistically significant discrepancy was found in the postoperative Tegner score in favor of ACL augmentation compared with ACL reconstruction (p < 0.05). Regarding the postoperative Lysholm score and KT-1000 measurement, no statistically significant difference was shown between ACL reconstruction and ACL augmentation (p > 0.05). ACL augmentation has proved to be an effective and safe procedure and should be preferred to ACL reconstruction in partial ACL tears for the tendency to achieve better functional outcomes. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Orthopaedic Walk-In Clinics: A model to lessen the burden on Emergency Departments during the COVID-19 pandemic.
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MacKechnie, Madeline C., Nadeau, Molly, Deering, Ericka, Thaller, John, and MacKechnie, Michael A.
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CLINICS ,EPIDEMICS ,HOSPITAL emergency services ,WORKING hours ,MEDICAL care ,MEDICAL care use ,MEDICAL emergencies ,MEDICAL referrals ,ORTHOPEDICS - Abstract
Operating duties for orthopaedic surgeons decreased during the COVID-19 pandemic, while Emergency Department (ED) cases surged. Orthopaedic Walk-In Clinics (OWICs) were implemented to manage urgent musculoskeletal cases. OWICs, organized in three days, were staffed by one orthopaedic surgeon, one triage person, three medical assistants, and a physician assistant/nurse practitioner. Musculoskeletal non-emergency ED referrals decreased by 40.6% (p < 0.001) after initiation of the OWICs, allowing optimal use of resources to address the COVID-19 surge. This paper describes the OWIC model and its preliminary impact. The OWICs could serve as a template for other orthopaedic departments during the pandemic. [ABSTRACT FROM AUTHOR]
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- 2020
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47. Bone grafting in primary and revision reverse total shoulder arthroplasty for the management of glenoid bone loss: A systematic review.
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Malahias, Michael-Alexander, Chytas, Dimitrios, Kostretzis, Lazaros, Brilakis, Emmanouil, Fandridis, Emmanouil, Hantes, Michael, and Antonogiannakis, Emmanouil
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ARTHROPLASTY ,BONE resorption ,BONE grafting ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDLINE ,ONLINE information services ,REOPERATION ,SHOULDER surgery ,SYSTEMATIC reviews - Abstract
We performed a systematic review of the studies including clinical/functional outcomes and complications of bone grafting for glenoid defects in reverse total shoulder arthroplasty (RTSA). The PubMed and Cochrane databases were searched for relevant papers. Thirteen articles were included. The mean clinical/functional subjective scores significantly improved postoperatively. The implant revision rate for primary and revision RTSA was 3.1% and 21.1% respectively. The reoperation rate was 3.5% and 24.4% respectively. There was moderate evidence that bone grafting is effective for glenoid defects in primary RTSA. Further high-quality research is required about revision RTSA for moderate-to-severe glenoid defects. [ABSTRACT FROM AUTHOR]
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- 2020
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48. Finite element assessment of metaphyseal sleeves in total knee arthroplasty.
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Frehill, B. and Crocombe, A.D.
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ARTIFICIAL joints ,BONE resorption ,FINITE element method ,PLASTIC surgery ,TIBIA ,TOTAL knee replacement - Abstract
This paper investigates the need to use stems in conjunction with cementless metaphyseal sleeves in total knee replacement (TKR) to treat cavity type-3 defects. Finite element models of TKR with type-3 defects of two sizes were modelled with and without stems. The use of sleeves result in stress concentrations at the bone/sleeve interface. The use of stems shows a reduction in these stresses but also an increased risk of bone resorption in the proximal tibia. Based on this investigation the authors recommend that stems are not required in TKR with cementless metaphyseal sleeves. [ABSTRACT FROM AUTHOR]
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- 2020
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49. Surgical modalities for the management of bone marrow edema of the knee joint.
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Ververidis, Athanasios N., Paraskevopoulos, Konstantinos, Tilkeridis, Konstantinos, Riziotis, Georgios, Tottas, Stylianos, and Drosos, Georgios I.
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ARTHROPLASTY ,ARTICULAR cartilage ,BONE marrow diseases ,EDEMA ,INFECTION ,KNEE ,KNEE diseases ,MEDLINE ,ONLINE information services ,OSTEOARTHRITIS ,SURGICAL complications ,TOTAL knee replacement ,SYSTEMATIC reviews ,PAIN measurement ,TREATMENT effectiveness ,SURGICAL decompression ,DISEASE risk factors - Abstract
Background: Bone marrow edema (BME) is a radiological term which can be found in many conditions with varied pathogenesis and histopathological images. It usually presents with pain in the affected joint and is diagnosed with MRI. Subchondroplasty (SCP) and core decompression (CD) are the surgical methods that are available to achieve pain relief and functional improvement. Both surgical methods have their own indications and are used depending on the patient's history. The aim of this literature review article is to discuss the surgical modalities for the management of bone marrow edema focusing on the knee joint. Such topic which analyzes both surgical methods for treatment of bone marrow edema of the knee joint has never been described in a review article before. Materials and methods: For the purpose of our manuscript we thoroughly searched electronic databases such as Pubmed and Medline to acquire the appropriate material for our review paper. Only English articles were used in this review. In our study we included every article that had described the surgical management of BME of the knee by CD and SCP. In the discussion we included 18 studies (9 CD and 9 SCP) with a total number of patients equal to 397, while 206/397 had undergone surgical intervention (169 underwent SCP and 37 CD). Results: Follow-up of 180 patients out of 206 were available for our review. A total number of 166 patients (92.2%) were successfully treated. Specifically, 29 (100%) patients were treated by CD and 137 (90.7%) by SCP. In a study, 10 patients who underwent SCP for BME secondary to advanced osteoarthritis (OA) yielded poor results. In other studies, pain persistency was observed in 2 patients, 1 patient had postoperative infection and another patient eventually underwent total knee arthroplasty (TKA). 70% prevention of TKA was achieved by SCP in a study of 66 patients with BME secondary to advanced OA. Thus, a total number of 166 patients were considered as clinical success and 14 patients as clinical failure. Conclusions: The included studies that have been published referred to the surgical methods of CD or SCP for the management of BME of the knee but none of that summarizes all current studies on both methods. Those studies seem that CD is a surgical technique that is proposed to perform in patients without findings of OA that usually fail to respond to conservative treatment. On the other hand, the option of SCP technique is carried out in patients with varied stage of OA associated with subchondral BME. Both methods aim to reduce the pain and to improve function in the setting of subchondral BME. Nevertheless it is not clear in literature which method is the best according to the criteria of the use. This literature review shows a lack of standardized guidelines with respect to diagnosis and surgical treatment. [ABSTRACT FROM AUTHOR]
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- 2020
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50. The most influential studies concerning revision shoulder arthroplasty research.
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Syros, Alina, Perez, Olivia F., Luxenburg, Dylan, Cohen, Jacob L., Swonger, Ronald, and Huntley, Samuel
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EVALUATION of medical care ,BIBLIOMETRICS ,SERIAL publications ,REOPERATION ,TOTAL shoulder replacement ,MEDICAL research - Abstract
Bibliometric analysis is a unique tool that can be used to study the characteristics and trends of a given topic. This study aimed to report on the most influential studies concerning revision shoulder arthroplasty research. On July 4th, 2022, the Institute of Scientific Information (ISI) Web of Knowledge Database was used to identify articles concerning revision shoulder arthroplasty research. The top 50 most cited articles were selected and analyzed. The mean number of citations was 142 (median: 97; range 599–70). Most articles were published in the 2010s (56%), followed by the 2000s (38%), and 1990s (6%). The most common level of evidence (LOE) was LOE II (42%) followed by LOE IV (38%), LOE I and III each had 10%. The greatest number of papers were published in the Journal of Shoulder and Elbow Surgery (46%), followed by the Journal of Bone and Joint Surgery- American Version (14%). This review can serve as a useful tool to study the most influential articles concerning revision shoulder arthroplasty research. Most of the articles were classified as clinical outcomes (62%), followed by natural history/epidemiology (12%), and surgical technique (10%). Our findings suggest that high-quality studies (LOE I) are lacking and other areas of research besides clinical outcomes are not as well studied. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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